Impact of perioperative fluid administration on early outcomes after pancreatoduodenectomy: A meta-analysis.

Abstract

BACKGROUND:

Pancreatoduodenectomy (PD) remains a technically challenging surgical procedure with morbidity rates ranging between 30 and 50%. It is suggested that the liberal use of fluids is associated with a poor perioperative outcome. This review examines the impact of fluid administration on outcomes after PD.

METHODS:

A literature search was conducted using the MEDLINE, EMBASE and PubMed database (June 1966-June 2016). Studies identified were appraised with standard selection criteria. Data points were extracted and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

RESULTS:

Eleven studies, seven retrospective trials and four randomized control trials comprising 2842 patients were included. Seven studies were meta-analyzed. There was no difference in length of hospital stay (P = 0.25), pancreas specific complications (P = 0.20), pulmonary (P = 0.58), cardiovascular (P = 0.75), gastrointestinal (P = 0.49), hepatobiliary (P = 0.53), urogenital (P = 0.42), wound complication (P = 0.79), reoperation rate (P = 0.69), overall morbidity (P = 0.18), major morbidity (P = 0.91), 30-day mortality (P = 0.07) and 90-day mortality (P = 0.58) in low or high fluid groups.

CONCLUSION:

The current available data fails to demonstrate an association between the amount of perioperative intravenous fluid administration and postoperative complications in patients undergoing PD.

• Authors: Yeqian Huang, Terence C Chua, Anthony J Gill, Jaswinder S Samra
• Journal: Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] (Pancreatology) 2017 May - Jun Vol. 17 Issue 3 Pg. 334-341 ISSN: 1424-3911 [Electronic] Switzerland
• PMID: 28285959 (Publication Type: Journal Article, Meta-Analysis, Review)
• Copyright: Copyright © 2017 IAP and EPC. Published by Elsevier B.V. All rights reserved.

Topics

• Fluid Therapy
• Humans
• Length of Stay
• Pancreatic Neoplasms (surgery)
• Pancreaticoduodenectomy (methods)
• Perioperative Care
• Postoperative Complications (epidemiology)
• Treatment Outcome